ASVMEB Order 22071 DENNIS WHITE, DVM

BEFORE THE ARIZONA STATE VETERINARY MEDICAL.
EXAMINING BOARD

IN THE MATTER OF: CASE No.: 22-71

DENNIS WHITE, DVM FINDINGS OF FACT,
HOLDER OF LICENSE No. 0885 CONCLUSIONS OF LAW
AND ORDER

FOR THE PRACTICE OF VETERINARY
MEDICINE IN THE STATE OF ARIZONA,

RESPONDENT.

Vee VeVe Ve Yee YD

The Arizona State Veterinary Medical Examining Board (“Board”)
considered this matter at its public meeting on July 20, 2022. Dennis White, DVM
(“Respondent”) appeared on his own behalf for an Informal Interview that was
held pursuant to the authority vested in the Board by A.R.S. § 32-2234(A). After
due consideration of the evidence, the arguments and the applicable law, the
Board voted to issue the following Findings of Fact, Conclusions of Law and
Order (“Order”),

FINDINGS OF FACT

1. Respondent is the holder of License No. 0885 and is therefore authorized
to practice the profession of veterinary medicine in the State of Arizona.

2. On October 28, 2021, “Jazz,” a 14.5 year-old female Australian Cattle Dog
was presented to Respondent with concerns that the underside of the dog's
tongue was red and possibly infected. Respondent noted the dog had severe
dental tartar and sublingual irritation on the left side. There were skin masses on
the ventral and right lateral thorax. Blood was collected for testing and an oral
evaluation with dental cleaning and possible extractions was scheduled for

November 3, 2021.

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3. On November 3, 2021, the dog was presented to Respondent's associate,
Dr. Adams, for an oral evaluation and dental with possible extractions. Blood
work previously performed was unremarkable. Complainant reported that the
dog was eating and drinking normally. She did not want any teeth extracted
unless called for permission. Upon examination, the dog appeared to be an
acceptable anesthetic candidate and if was agreed to proceed with the oral
evaluation.

4, An lV catheter was placed and LRS fluids were initiated. The dog was pre-
medicated with butorphanol and midazolam IM; induced with propofol IV; and
maintained on isoflurane and oxygen. Once under anesthesia, full mouth
radiographs were taken and an oral exam was performed. No masses or
abscessed teeth noted — there was no indication to extract teeth. Dr. Adams
stated that the dog had all the signs consistent with canine ulcerative
paradental stomatitis (CUPS). She discussed her findings and presumptive
diagnosis with Complainant. They spoke about the chronic painful condition
that only had one effective treatment which was to extract all teeth.
Respondent further advised that although the lesions in the dog’s mouth were
typically diagnostic of CUPS, she could not completely rule out autoimmune
disease or malignancy without histopathology. Complainant did not want to
extract the dog's teeth at that time and declined biopsy of abnormal gingiva.
After the dog's teeth were cleaned and polished, she recovered uneventfully.
The dog was discharged later that day with Clindamycin 150mg, 60 tablets;
give one tablet twice a day for 10 days each month; and BreathaLyser Water

Additive.

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5. At discharge, CVT Beck reviewed the discharge instructions with
Complainant including the recommendation to routinely brush the dog’s teeth,
administer the oral antibiotics, and add the dental additive to the dog's water.

6. Complainant commented that the dog's breathing was abnormal. CVT
Beck stated it was because the dog's throat was sore due to the endotracheal
tube. According to CVT Beck, he spoke with Complainant at length regarding
the CUPS diagnosis and the complications associated with it. He showed
Complainant the pictures taken of the dog's mouth while under anesthesia.
CVT Beck advised Complainant to start the antibiotics the next day and
Complainant left the premises.

7. On November 4, 2021, the dog was drinking less and showed no interest in
food. Later that afternoon, the dog started passing large amounts of bloody,
green snot, out of her mouth. Due to the dog not eating, Complainant did not
start the antibiotics because the instructions stated to give with food.

8. Complainant called the premises to report that the dog was not eating,
therefore, not receiving the antibiotics; furthermore, the dog was passing
bloody, green snot. Reception staff stated that there was not a veterinarian
available; therefore, technical staff was advised of what was transpiring.
Technical staff relayed that the dog was likely passing drool and it would be
fine if the dog went another day without antibiotics.

9. On November 5, 2021, the dog was presented to Respondent due to not

eating, passing bloody green mucous drool from mouth, and breathing

abnormally. Complainant was unable to give medication. Upon exam,
Respondent noted that the dog had red, inflamed gingiva due to CUPS

infection with increased saliva. Clindamycin 127mg was administered SQ and

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Entyce was dispensed and instructed to give 1.8mL SQ once a day.
Respondent recommended Compiadinant to be more aggressive with giving
the antibiotic and force feeding.

10. On November 6, 2021, Complainant called the premises to request pain
medication. The dog was not eating or drinking — Complainant was force
feeding the dog but the dog was resistant. Respondent approved pain
medication and dispensed carprofen and gabapentin.

11. The Board concluded that Respondent's conduct fell below the
standard of care due to not recommending follow up blood work to assess the
patient's condition, failing to recommend hospitalization with supportive care,
and recommending at-home care that did not provide for the patient's needs
which resulted in further suffering of the patient.

12. On November 7, 2021, the dog continued to be anorexic and lethargic;
therefore, Complainant presented the dog to Veterinary Specialty Center of
Arizona for evaluation. Dr. Vernasco examined the dog and discovered an oral
sublingual mass on the left side with associated purulent oral discharge, severe
dehydration, and marked inflammatory leukogram, electrolyte derangements,
azotemia, mild anemia and severe hyperproteinemia. The dog was hospitalized
for rehydration, supportive care and monitoring. IV fluids were administered
along with supportive medications.

13. That evening, the dog's care was transferred to Dr. Podmayer for
overnight monitoring and supportive care. The dog remained stable but the
fever persisted. Thoracic radiographs were performed and revealed no
evidence of pulmonary nodules. Recheck blood work showed improving

hypematremia but worsening hyperchloremia, as well as mild hypokalemia.

Dennis White, DVM

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14. The next day, the dog's care was transferred to Dr. Vernasco for
continued care. Complainant visited the dog and Dr. Vernasco expressed her
concern for an underlying issue that has not been identified. Blood work
changes were difficult to fully explain and diagnostics and treatments would
likely be extensive and they may make a diagnosis that cannot be treated.
After discussion with Dr. Vernasco and visiting the dog, Complainant elected to

humanely euthanize the dog.

CONCLUSIONS OF LAW

15. The conduct and circumstances described in the Findings of Fact above,
constitutes a violation of A.R.S. § 32-2232 (12) as it relates to A.A.C. R3-11-501
(1) failure to provide professionally acceptable procedures by not
recommending follow up blood work to assess the patient’s condition, failing to
recommend hospitalization with supportive care, and recommending al-home
care that did not provide for the patient's needs resulting in further suffering of
the patient.

ORDER

Based upon the foregoing Findings of Fact and Conclusions of Law it is
ORDERED that Respondent's License, No. 0885 be placed on PROBATION for a
period of one year, subject to the following terms and conditions that shall be
completed within the Probationary period. These requirements include six (6)
total hours of continuing education (CE) detailed below:

1. IT IS ORDERED THAT Respondent shall provide written proof satisfactory to
the Board that he has completed six (6) hours of continuing education (CE);

hours earned in compliance with this order shall not be used for licensure

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renewal. Respondent shall satisfy these six (6) hours by attending CE in the area
of diagnostics and examinations. Respondent shall submit written verification of
attendance fo the Board for approval.

2. IT IS ORDERED THAT Respondent shall pay a civil penalty of two hundred
fifty dollars ($250) on or before the end of the Probation period. Civil penalty
shall be made payable to the Arizona State Veterinary Medical Examining
Board and is to be paid by cashier's check or money order.

3. All continuing education fo be completed for this Order shall be pre-
approved by the Board. Respondent shall submit fo the Board a written outline
regarding how he plans to satisfy the requirements in paragraph 1 for its
approval within sixty (60) days of the effective date of this Order. The outline
shall include CE course details including, name, provider, date(s), hours of CE to
be earned, and a brief course summary.

4, Respondent shall obey all federal, state and local laws/rules governing
the practice of veterinary medicine in this state.

5. Respondent shall bear all costs of complying with this Order.

6. This Order is conclusive evidence of the matters described and may be
considered by the Board in determining an appropriate sanction in the event a
subsequent violation occurs. In the event Respondent violates any term of this
Order, the Board may, after opportunity for Informal Interview or Formal
Hearing, take any other appropriate disciplinary action authorized by law,
including suspension or revocation of Respondent's license.

NOTICE OF APPEAL RIGHTS
Respondent is hereby notified that he has the right to request a rehearing

or review of the Order by filing a motion with the Board's Executive Director

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within 30 days after service of this Order. Service of the Order is effective five
days after the date of mailing to Respondent. See A.R.S. § 41-1092.09. The
motion must set forth legally sufficient reasons for granting a rehearing or
review. A.A.C. R3-11-904. If a motion for rehearing or review is not filed, the
Board's Order becomes final 35 days after it is mailed to Respondent.
Respondent is further notified that failure to file a motion for rehearing or review
has the effect of prohibiting judicial review of the Order, according to A.R.S. §
41-1092.09(B) and A.R.S. § 12-904, et seq.

Dated this 24% day a 2022,

Arizona State Veterinary Medical Examining Board
Jessica Creager, Chairperson

Victoria Whitmore, Executive Director

Original of the foregoing filed this ae day of Bugust, 2022
with the:

Arizona State Veterinary
Medical Examining Board
1740 W. Adams St., Ste. 4600
Phoenix, Arizona 85007

Copy of the foregoing sent by certified, return receipt mail
this_ 24" day of Auguat _, 2022 to:

Dennis White, DVM
Address on file
Respondent

6 VWetinaee

Board Staff

22-71, Dennis White, DVM

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